Brain TumorsSeizures
may be the presenting sign of neonatal brain tumor. Seizures occur in
about 14% to 20% of newborns with brain tumors. Brain tumors in neonates
are more often supratentorial than infratentorial. Teratomas are the most
frequent supratentorial tumors in neonates. They are usually present at
the time of birth. Magnetic resonance imaging is the method of choice
to diagnose brain tumors. Treatment is surgical. Chemotherapy is sometimes
used. Radiotherapy is seldom used because of its deleterious effects on
future neurological development.More about...257, 288

SchizencephalySchizencephaly
consists of a canal, surrounded by cerebral cortex, that allows communication
between the subarachnoid space and the ventricles. Schizencephaly is diagnosed
by CT or preferably by MRI. The MRI appearance of schizencephaly is very
characteristic. It consists of a thin or wide canal that extends from
the cerebral cortex to the ventricles. Schizencephaly is unilateral or
bilateral. The walls of the clefts or lips exhibit abnormal cortex with
frequent neuronal heterotropia. The lips may be adjacent or distant from
each other. Schizencephaly occurs most often in the regions of the Rolandic
and Sylvian fissures. Schizencephaly may be associated with optic nerve
hypoplasia and absence of the septum pellucidum.Neonates with closed-lip schizencephaly
have a better prognosis than those with open-lip schizencephaly. Neonates
with unilateral schizencephaly have a better prognosis than those with
bilateral schizencephaly. Convulsions are treated with antiepileptic drugs.
Hemiparesis and mental retardation may occur. Hemiparesis is seldom present
in the neonatal period. The possibility of surgical treatment for medically
uncontrollable epilepsy should be considered in neonates with schizencephaly.
More about...257